Healthcare Provider Details

I. General information

NPI: 1902966070
Provider Name (Legal Business Name): ANZAR HAIDER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 11/02/2021
Certification Date: 11/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE # R3
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

9500 EUCLID AVE # R3
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 216-636-2107
  • Fax: 216-636-6761
Mailing address:
  • Phone: 216-636-2107
  • Fax: 216-636-6761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number35068942
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: